HUMAN ANATOMY & PHYSIOLOGY I

INTEGUMENTARY SYSTEM
Skin Structure & Function

DR WAN SAFWANI WAN KAMARUL ZAMAN

 MAIN FUNCTIONS
1.Protection: The most important function of the skin
is its effectiveness as a barrier between the internal
and external environments (guards against injury,
bacterial invasion, UV damage and desiccation).

2. Regulation of body temperature: mediated by the

hair coat, cutaneous blood supply, sweat glands.

3. Secretion: from sweat, sebaceous and mammary

glands

4. Sensory Organ: innervation of the skin provides

pain, touch, pressure and temperature sensation.

5. Immunity/Resistance

6. Synthesizes vitamin D
 OTHER FUNCTION
Reflects the physiological condition :
skin and coat
condition are good indicators of overall health and alterations
may reflect a variety of external and internal disease processes
(endocrine disorders, nutritional problems; i.e. Vitamin A
deficiency is characterized by very dry, hardened skin, dry lack-
luster hair and hair loss.)

Communication: The skin is an important organ in

the social life of animals because it gives off odors
that govern sexual behavior and helps animals
identify each other and their territories
 THE SKIN
• Surface area of 1.2 to 2.2 square
meters

• Weighs 4 to 5kg – about 7% of total

body weight

• Pliable & tough – against external

agents

• Thickness 1.5 to 4.0 mm

• 3 distinct regions:
1) Epidermis
2) Dermis
3) Hypodermis (subcutaneous tissue)

• Also includes all the accessory

structures found in the skin (hair,
glands, etc.)
EPIDERMIS
 EPIDERMIS
• OUTERMOST PROTECTIVE LAYER OF THE BODY

• AVASCULAR & NON-INNERVATED

• COMPOSED OF EPITHELIAL CELLS

- KERATINISED STRATIFIED SQUAMOUS
EPITHELIUM
- CONSISTING OF 4 CELL TYPES
- CONSISTING OF 4 OR 5 LAYERS
 THICKNESS OF EPIDERMIS

Thin Skin Thick skin

• Covers most of the • Covers the palms of
body the hands and soles
• Has 4 layers of of the feet
keratinocytes • Has 5 layers of
keratinocytes
 CELLS OF THE EPIDERMIS
1) KERATINOCYTES

• Produce keratin – fibrous protein

• Tightly connected by desmosomes

• Arise in the deepest part of epidermis – stratum

basale

• Cells are pushed upward by new cells

• Dead cells when reach surface – scale-like

structure

• Formation accelerated in areas subject to regular

friction

• Persistent friction - callus

 CELLS OF THE EPIDERMIS
2) MELANOCYTES

• Spider-shaped epithelial cells

• Synthesised pigment melanin –deepest
layer of epidermis
• Accumulated in membrane-bound
granules – melanosomes
• Melanosomes – are moved along actin
filaments by motor proteins to the ends of
melanocyte’s processes.
• Granules accumulate on superficial side of
keratinocytes nucleus – pigment shield
• Pigment shield – protects nucleus from UV
light.
• Stable population of cells
 CELLS OF THE EPIDERMIS
3) MERKEL CELLS

• An exteroreceptor located in the

stratum germinativum of the
epidermis
• A small receptor resembling a spiky
hemisphere which communicates
with the disk-like sensory terminal of
a neuron
• The combined structure is termed a
Merkel or tactile disc
• They are receptors for light or
discriminative touch
• Function as touch receptors in
association with sensory nerve
endings
 CELLS OF THE EPIDERMIS
4) LANGERHANS’ CELLS

• Arise from red bone marrow and

migrate to the epidermis
• Epidermal macrophages that help
activate the immune system
• Phagocytes – ingest foreign
substances
• Easily damaged by ultraviolet light.
LAYERS OF EPIDERMIS
Layers of the epidermis are known as “strata”
 LAYERS OF EPIDERMIS

Top: Free surface of skin

- stratum corneum
- stratum lucidum
- stratum granulosum
- stratum spinosum
- stratum germinativum
Bottom: Basal lamina
 STRATUM GERMINATIVUM (BASALE)
• The “germinative layer” (or basal layer):

– Deepest epidermal layer firmly attached to the

basal lamina and dermis via hemidesmosomes
– Consists of a single row of the youngest
keratinocytes along with projections of
melanocytes
– Cells undergo rapid division,
– 10 – 25% of cells are melanocytes
 STRUCTURE OF STRATUM
GERMINATIVUM
• Epidermal ridges
– cause the pattern of your fingerprints;
– created by presence of:

• Dermal papillae (tiny mounds):

– increase the area of basal lamina
 Fingerprints are epidermal ridges

• Which themselves are

negative images of the dermal
papilla

• Epidermal ridge patterns –

genetically determined &
unique

• Fingerprints –due to sweat

pores open along crests
 STRATUM SPINOSUM
• “Prickly layer”

• 8-10 cells (keratinocytes) thick

• Immature keratinocyte cells continue to divide, then shrink

until cytoskeletons stick out (irregular).

• a system of intermediate filaments (pre-keratin filaments)

attached to desmosomes

• Melanin granules and Langerhans’ cells are abundant in this

layer
STRATUM GRANULOSUM (GRAINY LAYER)
• Consists of 3 – 5 cell layers

• Cells flatten, nuclei & organelles disintegrate

• Accumulate 2 types of granules (proteins):

1) keratohyaline – form keratin in upper layers
2) lamellated – waterproofing glycolipid – spewed into EC space
to dehydrate epidermis.

• Resistant to destruction
 STRATUM LUCIDUM (CLEAR LAYER)
• Appear as thin translucent band.

• Only found in thick skin

• Just above granulosum

• Consists of a few rows of flat, dead keratinocytes filled with

keratin

• The layer appears, ironically, very thin in slides

• Probably functions to hold on the thicker corneum layer

above
 STRATUM CORNEUM (HORNY LAYER)
• Exposed surface of skin
• 15 to 30 layers of keratinized cells
• Accounts for ¾ of epidermal thickness
• Water resistant
• Protects from abrasion and penetration
• Shed and replaced every 2 - 4 weeks

Skin is often called a cornified epithelium

 SKIN LIFE CYCLE

• It takes 15–30 days for a cell to move from

stratum germinosum to stratum corneum

• It takes longer in older people – about 37 days

DERMIS
Dermis consists of connective tissue
 DERMIS
• Deeper part of cutaneous layer

• Located between epidermis and subcutaneous layer

• Anchors epidermal accessory structures (hair follicles, sweat

glands)

• Contains strong, flexible connective tissue

• Cell types include fibroblasts, macrophages, and occasionally mast

cells and white blood cells

• Has 2 components:
– outer papillary layer
– deep reticular layer
 THE PAPILLARY LAYER
• Consists of areolar tissue with collagen and elastic fibers

• Contains smaller capillaries, lymphatic vessels, and sensory neurons

• Has dermal papillae projecting between epidermal ridges

• Dermal papillae – contain capillary loops, free nerve endings (pain),

Meissner’s corpuscles ( touch).

• On palms of hands & soles of feet – papillae lie atop larger mounds called
dermal ridges – overlying dermis to form epidermal ridges

• Increase friction & enhance gripping ability of fingers & feet

 THE RETICULAR LAYER
• Consists of dense irregular connective tissue

• Accounts for approximately 80% of the thickness of the skin

• Contains larger blood vessels, lymph vessels, and nerve fibers

• Network of blood vessels – cutaneous plexus lies between this layer

& hypodermis.

• Collagen fibers in this layer add strength and resiliency to the skin

• Elastin fibers provide stretch-recoil properties Contains collagen and

elastic fibers
 DERMIS
FLEXURE LINES

• Dermal modification

• Skin cannot slide easily to accommodate joint

movement.

• Dermal folds – at or near joints

 HYPODERMIS (SUBCUTANEOUS LAYER)
• Superficial fascia:

– loose connective tissue - areolar and adipose

– connected to the reticular layer of dermis by
connective tissue fibers
– stabilizes the skin
– allows separate movement
– Insulates and stores energy
– location of hypodermic injections
 SKIN
APPENDAGES
 ACCESSORY STRUCTURES

• Are of epidermal lineage (cells are modified

epithelial cells)
• Start from the formation epithelial bud
• Stimulated by reduced production of cell adhesion
factor (cadherin).
• Extend through the epidermis to skin surface:
– Hair & follicles
– nails
– multicellular exocrine glands (sebaceous, sweat)
 SUDORIFEROUS GLANDS (SWEAT GLAND)
• Distributed over entire skin except nipples & parts of external genitalia.

• 2 types:

1) Merocrine (Eccrine)
– More numerous, widely distributed on body surface, especially on
palms and soles (thick skin)
– Produce thin sweat for evaporative coolling
– Secretary part coiled in dermis & duct extends in funnel-shaped at
skin surface.

2) Apocrine
– Largely confined to axillary & anogenital areas.
– Large & ducts empty into hair follicles.
– Sweat has basic components + fatty substance + proteins
– Texture of sweat: thick, viscous, milky, yellowish
– Activated by sympathetic during pain & stress.
SUDORIFEROUS GLANDS (SWEAT GLAND)
 SWEAT
• Hypotonic filtrate of blood

• Released by exocytosis

• Contain: 1) 99% water with some salt

2) vitamin C
3) antibodies
4) dermicidin
5) metabolic wastes e.g urea

• Acidic – pH 4 – 6

• Control by sympathetic division

• Function: prevent over-heating of body

• Exact composition – hereditary & diet.

 SEBACEOUS GLANDS (OIL)
• Simple branched alveolar glands

• Found all over body except palms & soles

• Small on body trunk & limbs but large on face, neck & upper chest

• Holocrine glands - Secretes sebum consist of lipids & cell fragments

• Function of Sebum – Lubricates and protects the hair and skin epidermis
- Inhibits bacterial growth

• Sebaceous glands:
– associated with most hair follicles (on head and body)

• Sebaceous follicles:
– discharge directly onto skin surface
– found on face and trunk only
– when clogged  acne

• Secretion of sebum is stimulated by hormones - androgens

SEBACEOUS GLANDS (OIL)
 SEBACEOUS GLANDS (OIL)
Whitehead
Sebaceous gland duct is blocked – accumulated sebum

Blackhead
Accumulated sebum become oxidizes & dries – darkens

Acne
Active inflammation of sebaceous glands accompanied by pustules or cysts
Bacterial infection

Seborrhea
Cradle cap in infants
Overactive sebaceous glands
Begins in scalp as pink raised lesion – yellow to brown & slough off oily scales.
 Other Integumentary Glands
Specialized sweat glands:
• Mammary glands:
– produce milk
• Ceruminous glands:
– protect the eardrum
– produce cerumen (earwax)
 HAIR (PILI)
• Flexible strands produced by hair follicles
• Consists of dead & keratinised cells
• Hard keratin : 1) tougher & durable & 2)
individual cells do not flake off
• Chief regions
1) Shaft – projects from skin
2) Root – embedded in skin
• 3 concentric layers of keratinised cells
1) Medulla – large cells & air spaces
- absent of fine hairs
2) Cortex – bulky layer consists of several
layers of flattened cells.
3) Cuticle – formed from single cell layer
that overlap one another.
 HAIR
• Arrector pili:
– involuntary smooth muscle
– causes hairs to stand up
– produces “goose bumps”
• Sebaceous glands:
– lubricate the hair
– control bacteria
 HAIR FOLLICLE
• Fold down from epidermal surface into dermis

• Hair bulb – below skin surface

- expanded from deep end of follicle

• Hair follicle receptor/root hair plexus

- wraps around each hair bulb
- sensory nerve endings – sensitive touch receptors

• Papilla – dermal tissue protrudes into hair bulb

- contains capillaries – supply nutrients

• Wall composed:
1) connective tissue sheath (outer)
- derived from dermis
- thickened basement membrane
2) epithelial root sheath (inner)
- derived from invagination of epidermis

• Hair matrix – actively dividing area of hair bulb

– produces hair
 HAIR COLOUR
• Hair pigment made of melanocytes at base of hair follicle

• Transferred to cortical cells

• Melanins of different colours – yellow, rust, brown, black

• Red – iron-containing pigment – trichosiderin

• Gray or white – decreased melanin production

- replacement of melanin by air bubbles in hair
shaft
 TYPES OF HAIR
Vellus Hair
• Pale & fine
• Body hair of children & adult females

Terminal Hair
• Coarser, longer hair on eyebrows & scalp
• Axillary & pubic regions at puberty
• Darker
• Grow in response to androgens in male
 NAIL
• Scale-like modification of epidermis
• Clear protective covering of distal part of finger or toe
• Contain hard keratin
• Has free edge, a body & proximal root.
• Nail matrix – thickened proximal portion of nail bed
• Lunula – white crescent
• Eponychium – projects from proximal nail fold
• Hyponychium – beneath free edge of nail
 SKIN COLOUR

3 PIGMENTS CONTRIBUTE TO SKIN COLOUR:

1) MELANIN

2) CAROTENE

3) HEMOGLOBIN
 MELANIN
• Made in the skin
• Polymer from tyrosine amino acids
• Synthesis depends on enzyme tyrosinase in melanocytes.
• Skin colour – reflects the relative kind & amount of melanin made.
• Freckles & pigmented moles – local accumulation of melanin.
• Melanocytes – stimulated to greater activity when expose to sunlight.
 FUNCTION OF MELANOCYTES
• Ultraviolet (UV) radiation:
– causes DNA mutations and burns which lead to
cancer and wrinkles

• Melanin protects skin from sun damage

• Pigment molecules absorb UV and diffuse it,

preventing it from penetrating to the DNA of
cells in the strata germinativum and spinosum
 CAROTENE
• Yellow to orange pigment

• Tends to accumulate in stratum corneum & fatty tissue of

hypodermis.

• Obvious in palms & soles

• Minor factor
 HEMOGLOBIN
• Pinkish hue of fair skin

• Oxygenated hemoglobin in RBCs circulating through

dermal capillaries
 DERMAL CIRCULATION
• Arteries
– Cutaneous plexus: a network of arteries along the bottom
of the reticular layer
– Papillary plexus: capillary network from small arteries in
papillary layer
• proximate source of nutrients for epidermal cells
• Cells in the s. corneum are too far away to be nourished through
difusion – that’s why they are dead
• Venous plexus:
– capillary return deep to the papillary plexus
– Bruises usually occur from breakage of these vessels
 Capillaries and Skin Color

• Oxygenated red blood contributes to skin

color:
– blood vessels dilate from heat, skin reddens
(erythema)
– blood flow decreases, skin pales
– corpses appear pale and lighter because they lack
this coloration
 Cyanosis
• Bluish skin tint
• Caused by severe reduction in blood flow or
oxygenation
• The veins appear blue when blood is
deoxygenated but deoxegenated blood is NOT
blue – it is darker red
 Illness and Skin Color
• Jaundice:
– buildup of bile produced by liver
– yellow color
• Addison’s disease:
– and other diseases of pituitary gland
– skin darkening – brownish pigmentation
• Vitiglio:
– loss of melanocytes
– localized loss of color
 Vitamin D
• The “sunshine vitamin”
• Epidermal cells produce cholecalciferol
(vitamin D3) in the presence of UV radiation
• Liver and kidneys convert vitamin D into
calcitriol which aids in absorption of calcium
and phosphorus at the intestines
• Insufficient vitamin D:
– can cause rickets
– Symptoms?
 BRUISES

• Black & blue marks

• Blood escaped from circulation & clotted
beneath skin.
• Hematomas
 Skin Damage
• Sagging and wrinkles (reduced skin elasticity)
are caused by loss (or decresed production) of
collagen and elastin by fibrolasts, due to:
– dehydration
– age
– hormonal changes
– UV exposure
 Skin color tradeoff?
• Vitamin D is necessary for bone strength, but if
there is not much UV (high latitudes), individuals
with a lot of melanin have trouble getting enough
Vit D. But when UV is plentiful, they are better
protected from skin cancer.
• On the other hand, in places with a lot of UV (low
latitudes), people with very little melanin are at
high risk of skin cancer. But they are more likely
to get enough UV from the sun in low UV regions.
 Skin Cancer
• The three major types of skin
cancer are:
– Basal cell carcinoma (s.
germinativum)
– Squamous cell carcinoma (s.
spinosum)
– Melanoma
• The vast majority of all skin
cancers are of the first two
types (basal and squamous)
• They rarely metastasize and
can be taken care of by
excision; thus they are not
included in most cancer
statistics
 Melanoma
• Cancer of melanocytes is the most dangerous
type of skin cancer because it is:
– Highly metastatic
– Resistant to chemotherapy
• Kind of ironic because they evolved to protect
basal cells, but basal cell cancer has a much
better prognosis
REPAIR OF LOCALISED INJURY: STEP 1

• Bleeding occurs
• Mast cells trigger
inflammatory
response
 REPAIR OF LOCALISED INJURY: STEP 2

• A scab stabilizes and

protects the area
 REPAIR OF LOCALISED INJURY: STEP 3

• Fibroblasts
produce scar tissue
• Inflammation
decreases, clot
disintegrates
 REPAIR OF LOCALISED INJURY: STEP 4

• Fibroblasts
strengthen scar
tissue
• A raised keloid forms